The Influence of State‐Ownership on Eco‐Innovations in Russian Manufacturing Firms

This paper studies drivers for eco‐innovation in Russian manufacturing firms on a sample of 2,212 innovative firms, of which over 600 introduced eco‐innovations. The companies in our sample specifically mention environmental regulation as a reason for engaging in eco‐innovations. Furthermore, we show that those firms who engage in eco‐innovations are motivated even stronger by the desire to increase resource efficiency. Companies under state ownership are especially prone to a higher likelihood to invest. We conclude that regulations are mostly relevant to the late comers who are obliged to follow minimum standards. On the other hand, the state uses its controlling influence to press companies under their control to exceed these minimum standards. Thus, we argue, state ownership does indeed have an influence on both the likelihood to eco‐innovate and on the levels of spending. Eco‐innovative state‐owned companies are only prone to invest in eco‐innovations, if they get additional money.     

Effect of a geriatric consultation service on management of patients in an acute care hospital.

Elderly patients present particular management challenges. We conducted a randomized clinical trial of the effect of a geriatric consultation service on the management of elderly patients in an acute care hospital. A total of 113 patients aged 75 years or more who met certain criteria were assigned to either receive (57 patients) or not receive (56) care by the service. At the end of their hospital stay the patients were assessed with regard to predetermined outcomes. The patients were followed up for 1 year after discharge to determine death rates and direct health care expenditures. The intervention group showed significantly greater improvement in mental status (p less than 0.01), were receiving fewer medications at discharge (p less than 0.05) and had lower short-term death rates (p less than 0.05) than the control group. A geriatric consultation service can improve the hospital care and health of the elderly.     

Beneficial effects on employment and preventive health care: the concept and results of counselling processes from a German project

Since December 1998 a project of working time counselling named "Design of Modern Working Times" is supported by the federal state of North Rhine-Westphalia in Germany and the European Union; AWiS-consult is entrusted to carry out this project. The service offered to all companies, institutions, work committees, and employees interested covers information, assessment of existing working time schedules, development of alternative or new working time schedules, and accompanying implementation processes. Up to June 2001 nearly 300 inquiries were worked on, most of them from industry, service companies, and from the field of care and hospitals. Working time design in this project aims not only at work safety and health care but also at beneficial effects on employment. In a special campaign from May 2000 to May 2001, 61 companies were supported by AWiS-consult, with the result of more than 400 new employees and 16 companies with employment secured, so the combination of preventive health care and beneficial effects on employment by working time design can be assessed as successful.     

Costes por incapacidad temporal en España derivados de la diabetes mellitus y sus complicaciones

Introduction and objectivesTo ascertain the socioeconomic impact of diabetes, it is essential to estimate overall costs, including both direct and indirect costs (premature retirements, working hours lost, or sick leaves). This study analyzed indirect costs for temporary disability (TD) due to diabetes and its complications in Spain in 2011 by assessing the related ICD-9 MC codes.Material and methodFor this purpose, the number of TD processes and their mean duration were recorded. The indirect costs associated to loss of working days were also estimated.ResultsIn 2011, diabetes and its complications were related to 2.567 TD processes, which resulted in the loss of 154.214 days. In terms of costs, this disease represented for Spanish public health administrations an expense of 3,297.095.3 €, with an estimated cost per patient and year of 141 €.ConclusionsThese data suggest an urgent need to devise plans for prevention and early diagnosis of diabetes and its complications, as well as programs to optimize the available health care resources by creating multidisciplinary teams where occupational medical services assume an important role. A decrease in absenteeism would result in benefits for diabetic patients, society overall, and companies or public institutions.     

Randomised controlled trial of an occupational therapy intervention to increase outdoor mobility after stroke

Objective To evaluate an occupational therapy intervention to improve outdoor mobility after stroke.Design Randomised controlled trial.Setting General practice registers, social services departments, a primary care rehabilitation service, and a geriatric day hospital.Participants 168 community dwelling people with a clinical diagnosis of stroke in previous 36 months: 86 were allocated to the intervention group and 82 to the control group.Interventions Leaflets describing local transport services for disabled people (control group) and leaflets with assessment and up to seven intervention sessions by an occupational therapist (intervention group).Main outcome measures Responses to postal questionnaires at four and 10 months: primary outcome measure was response to whether participant got out of the house as much as he or she would like, and secondary outcome measures were response to how many journeys outdoors had been made in the past month and scores on the Nottingham extended activities of daily living scale, Nottingham leisure questionnaire, and general health questionnaire.Results Participants in the treatment group were more likely to get out of the house as often as they wanted at both four months (relative risk 1.72, 95% confidence interval 1.25 to 2.37) and 10 months (1.74, 1.24 to 2.44). The treatment group reported more journeys outdoors in the month before assessment at both four months (median 37 in intervention group, 14 in control group: P < 0.01) and 10 months (median 42 in intervention group, 14 in control group: P < 0.01). At four months the mobility scores on the Nottingham extended activities of daily living scale were significantly higher in the intervention group, but there were no significant differences in the other secondary outcomes. No significant differences were observed in these measures at 10 months.Conclusion A targeted occupational therapy intervention at home increases outdoor mobility in people after stroke.     

Industry calling! Is there a doctor in the house?

Medical service is needed in industry by both management and labor as never before. Industry is just beginning to awaken to this need. The medical profession is largely unaware of it. Unless physicians are prepared to heed this call, there is danger that management and labor will come to a bipartisan agreement over the bargaining table which will specify the amount, quality, and price of medical service irrespective of the effects of such an agreement on the practice of medicine. Such agreements should invariably be tripartite-between management, labor and medicine-if we are to continue to strive for medicine's traditional ideals: The best of medical care for all alike. This situation imposes at least two important obligations on organized medicine at the national level and especially at state and local levels where there is industrial concentration:1. Provision of a strong and competent committee or council whose members are especially interested in occupational medicine and who will make their presence known to management and labor alike, offering to advise with them on all medical problems, to mediate their disagreements or medical questions, and to help them attain a common goal.2. Assisting the members of organized medicine who are interested, to learn more about the medical problems peculiar to occupational health.     

Occupational illness and poison control centers. Referral patterns and service needs.

In a study of occupational illness reported to a regional poison control center and to gauge the center''s outreach and services, we did follow-up interviews of 301 case contacts over a 6-month period. We ascertained referral routes, reasons for contacting the poison control center, and awareness of the center''s function. For 122 cases a nonphysician was the initial poison control center contact. Of the nonphysician contacts, 41 had already consulted a health care provider and been referred to the poison control center for assistance. Of the 70 persons with exposure, only 21 had been aware before their exposures that poison control center services might include occupational chemical illness consultation. Physicians and nonphysicians expressed similar reasons for contacting the poison control center, with 118 of 301 identifying the need for an exposure hazard risk assessment. These data suggest that although those contacting a poison control center because of occupational illness include a variety of cases, they have many similar service needs.     

INDUSTRY CALLING!—Is There a Doctor in the House?

Medical service is needed in industry by both management and labor as never before. Industry is just beginning to awaken to this need. The medical profession is largely unaware of it. Unless physicians are prepared to heed this call, there is danger that management and labor will come to a bipartisan agreement over the bargaining table which will specify the amount, quality, and price of medical service irrespective of the effects of such an agreement on the practice of medicine. Such agreements should invariably be tripartite—between management, labor and medicine—if we are to continue to strive for medicine''s traditional ideals: The best of medical care for all alike.This situation imposes at least two important obligations on organized medicine at the national level and especially at state and local levels where there is industrial concentration:1. Provision of a strong and competent committee or council whose members are especially interested in occupational medicine and who will make their presence known to management and labor alike, offering to advise with them on all medical problems, to mediate their disagreements or medical questions, and to help them attain a common goal.2. Assisting the members of organized medicine who are interested, to learn more about the medical problems peculiar to occupational health.     

Renal dysfunction of cadmium-exposed workers residing in a cadmium-polluted environment

Human exposure to cadmium may occur in both occupational and general environments. We were interested in determining whether a combination of occupational and environmental exposure to cadmium results in different levels of severity of renal dysfunction relative to that arising from environmental or occupational exposure alone. We selected 44 residents, who once were employed in a smelter and lived in a cadmium-polluted area, as group A. Another 88 subjects, who never worked in the plant, but lived in the same area, were selected as group B. Group C consisted of 88 subjects who had no history of occupational exposure to cadmium and lived in a non-cadmium-polluted area. Statistical analysis demonstrated that there was no significant difference in age or gender among the three groups, nor were there significant differences in smoking habits. The prevalence of renal dysfunction as indicated by increased excretion of beta2-microglobulin (B2M), N-acetyl-beta-D-glucosaminidase (NAG) and albumin (ALB), was higher in group A than in group B. This finding suggests that exposure to cadmium both occupationally and environmentally results in a higher prevalence of renal dysfunction, relative to those who are exposed to cadmium only in the general environment. Therefore, this specific population, who once were occupationally exposed to cadmium and lived in polluted areas, should be identified. Furthermore, health examinations of this population should be conducted in time to prevent further health damage induced by cadmium exposure.     

Investigation on psychological state of occupational exposure of medical staff in operation room under novel coronavirus

This article mainly explores the psychological state of occupational exposure of medical staff in operation room contaminated with novel coronavirus, and provides targeted suggestions for mental health service of medical staff so as to maintain their physical and mental health. On February 28, 2020, a questionnaire survey was conducted using Internet. Nurses, anesthesiologists and surgeons in the operating room of the First Affiliated Hospital of Harbin Medical University from January 2020 to March 2020 were selected as the research objects. The psychological state of medical staff was investigated by SAS and PSS-14. As on February 29, 2020, 301 valid questionnaires and one invalid questionnaire were received. The survey showed that there was anxiety but no moderate or severe anxiety in the occupational behavior of operating room medical staff, while some medical staff had a certain degree of psychological pressure (P < 0.05). The present survey suggested that medical staff was under anxiety and pressure in different degrees in the operation room because of novel coronavirus contamination during occupational activities, much attention is required to improve mental health of medical professionals and to reduce their negative emotions.     

Assessing the quality of service to customers provided by water utilities: A synthetic index approach

Currently, water and sewer companies face the challenge of improving their quality of service to customers (QSC). Performance indicators are essential to monitor and benchmark the QSC of water companies; however, individual indicators do not provide a holistic evaluation of the quality of water and sewer services provided to customers. This study proposes an innovative QSC index based on distance-function techniques that makes it possible to compare changes in the QSC of water companies among locations and temporal periods. A case study assesses changes in QSC for a sample of Chilean water and sewer companies from 2007 to 2014. The results show that in spite of the efforts made by the water regulator, QSC has remained almost constant over a number of years, with 2010 having the best performance. The methodology proposed in this study is useful for water regulators to benchmark water companies when developing policies that prompt QSC improvements.     

Is there a health hazard for building occupants of airborne mineral fibers exposure?

Summary Asbestos containing material (ACM) inside buildings is an important concern for the health of their occupants. In France, for the assessment of airborne asbestos concentrations inside building, we use the indirect TEM measurement method constantly improved from 1978 on. By contrast, in the U.S.A. and UK the direct method is used. We have carried out a study in order to compare mass and numerical concentration fibres from the same samples, the tendency being now to express the results in fibre/litre. Concerning asbestos fibres released from man made mineral fibres (MMMF), optical microscope is used and results are expressed in numerical concentrations. Epidemiological studies of different occupational cohorts suggest that amphibole fibres present a greater health risk than chrysotile. Concerning indoor pollution by mineral wool, the health hazard seems negligible. The appraisal of this public health problem remains to be done. In France, a multidisciplinary study group has been created to provide advices related to corrective actions. Information on this public health problem is expected from the epidemiologic longitudinal survey, still in progress, of a cohort of workers, exposed to ACM in Paris university buildings.     

Benefits of effective hospital services for elderly people.

An age related hospital service for elderly people was set up in Waltham Forest Health Authority to provide acute medical care when needed. Despite a reduction in the allocation of funds over the years 1982-4 the health authority increased the number of district general hospital beds available for elderly patients and improved home nursing services. The outcomes of the changes made were assessed against the aims of the service by using data from the Hospital Activity Analysis, SH3 returns, government population estimates, and yearly figures collected in our department. It is concluded that introducing an age related service in our health authority has benefited people aged over 65.     

Objectively Measured Total and Occupational Sedentary Time in Three Work Settings

Background

Sedentary behaviour increases the risk for morbidity. Our primary aim is to determine the proportion and factors associated with objectively measured total and occupational sedentary time in three work settings. Secondary aim is to study the proportion of physical activity and prolonged sedentary bouts.

Methods

Data were obtained using ActiGraph accelerometers from employees of: 1) a financial service provider (n = 49 men, 31 women), 2) two research institutes (n = 30 men, 57 women), and 3) a construction company (n = 38 men). Total (over the whole day) and occupational sedentary time, physical activity and prolonged sedentary bouts (lasting ≥30 minutes) were calculated by work setting. Linear regression analyses were performed to examine general, health and work-related factors associated with sedentary time.

Results

The employees of the financial service provider and the research institutes spent 76–80% of their occupational time in sedentary behaviour, 18–20% in light intensity physical activity and 3–5% in moderate-to-vigorous intensity physical activity. Occupational time in prolonged sedentary bouts was 27–30%. Total time was less sedentary (64–70%), and had more light intensity physical activity (26–33%). The employees of the construction company spent 44% of their occupational time in sedentary behaviour, 49% in light, and 7% in moderate intensity physical activity, and spent 7% in sedentary bouts. Total time spent in sedentary behavior was 56%, 40% in light, and 4% in moderate intensity physical behaviour, and 12% in sedentary bouts. For women, low to intermediate education was the only factor that was negatively associated with occupational sedentary time.

Conclusions

Sedentary behaviour is high among white-collar employees, especially in highly educated women. A relatively small proportion of sedentary time was accrued in sedentary bouts. It is recommended that worksite health promotion efforts should focus on reducing sedentary behaviour through improving light intensity physical activity.     

Ethical, legal and social issues in nutrigenomics: the challenges of regulating service delivery and building health professional capacity

Nutrigenomics, the conjunction of molecular nutrition with human genomics, is among the first publicly available applications of the human genome project. Nutrigenomics raises ethical, legal and social issues particularly with respect to how the public may access nutrigenetic tests and associated nutritional and lifestyle advice. Current regulatory controversy focuses on potential harms associated with direct-to-consumer (DTC) marketing of nutrigenetic tests and especially the need to protect consumers from unreliable tests, false claims and unproven dietary supplements. Nutrigenomics does, however, offer the potential of important health benefits for some individuals. The regulation of nutrigenomic services is slowly evolving, but there is little indication of increased professional capacity to support service delivery. Primary care physicians have minimal training in nutrition and genetics, and medical geneticists are in high demand and short supply. Dietetic practitioners are experts in nutrition science and interest in nutrigenomics is growing among members of this professional group. However, as with physicians, dietetics practitioners would require considerable training to bring nutrigenomics into their practice capacity. A downside of regulatory restrictions on direct consumer access to nutrigenomics companies is that responsible businesses may be hindered in meeting emergent public demand while health care professional groups have not yet developed capacity to provide nutrigenomics services.     

The Relation between Occupational Sitting and Mental,Cardiometabolic, and Musculoskeletal Health over a Period of 15 Years – The Doetinchem Cohort Study

Objective

Sedentary behaviors are reported to impose health risks. Since occupational exposure is a major proportion of total sedentary time, we studied the association between occupational sitting and a number of health problems.

Methods

From the longitudinal Doetinchem Cohort Study, we selected those working at baseline with complete data (n = 1,509). Participants were examined four times at 5 year-intervals between 1993 and 2012. We characterized occupational sitting as follows: 1) stable sitters and stable non sitters over a 15-year period, based on job characteristics and (2) having a job with a low, moderate or high amount of sitting, based on tertiles of self-reported number of hours per week of occupational sitting, measured at wave 5. Linear and logistic regression models were used. Outcomes were self-reported mental health, low-back or upper extremity pain, and objectively measured cardiometabolic health (overweight, hypertension, hypercholesterolemia).

Results

Compared to stable non sitters, a lower risk of chronic upper extremity pain was observed for stable sitters (OR 0.75, 95% CI: 0.57; 1.00) as well as for those in the two upper tertiles for hours of occupational sitting (>4 hr/wk) (OR 0.65; 95%CI 0.50–0.86). For the other health outcomes studied, no significant associations were found with occupational sitting.

Conclusion

Our findings do not support the hypothesis that occupational sitting is associated with health problems. The finding that occupational sitting is associated with less upper extremity pain might be due to the association of occupational sitting with less physical load.     

Occupational Risks and Exposures Among Wildlife Health Professionals

Most emerging infectious diseases are zoonotic in origin, with wildlife a frequent source of zoonotic disease events. Although individuals with extensive wildlife contact may be at the greatest risk of contracting novel infectious agents, the occupational risk of those working closely with wildlife has not been well studied. This study assessed the occupational exposures among wildlife health professionals working in multiple countries worldwide. An occupational risk survey of past and present exposures was developed and administered online in a confidential manner to wildlife workers recruited through an ongoing international wildlife pathogen surveillance project. Surveys were completed by 71 participants in 14 countries. Significant lifetime exposures reported included bites from bats and rodents and touching dead animals. Completion of training in occupational safety was reported by 75% of respondents. While gloves were used for most tasks, use of N95 respirators and other personal protective equipment varied by task. Eighty percent of workers reported rabies vaccination. Some respondents indicated interest in enhanced occupational health services targeting their unique needs. Wildlife workers represent an occupational population at risk of zoonotic infection and injury. Enhanced occupational health services targeting wildlife workers could reduce the risk and sequelae of zoonotic exposure and infection.     

Improving Health Worker Adherence to Malaria Treatment Guidelines in Papua New Guinea: Feasibility and Acceptability of a Text Message Reminder Service

The aim of this study is to assess whether a text message reminder service designed to support health worker adherence to a revised malaria treatment protocol is feasible and acceptable in Papua New Guinea (PNG). The study took place in six purposively selected health facilities located in the Eastern Highlands Province (EHP) of PNG. Ten text messages designed to remind participants of key elements of the new NMTP were transmitted to 42 health workers twice over a two week period (two text messages per day, Monday to Friday) via the country’s largest mobile network provider. The feasibility and acceptability of the text message reminder service was assessed by transmission reports, participant diaries and group discussions. Findings indicate that the vast majority of text messages were successfully transmitted, participants’ had regular mobile phone access and that most text messages were read most of the time and were considered both acceptable and clinically useful. Nevertheless, the study found that PNG health workers may tire of the service if the same messages are repeated too many times and that health workers may be reluctant to utilize more comprehensive, yet complementary, resources. In conclusion, a text message reminder service to support health worker adherence to the new malaria treatment protocol is feasible and acceptable in PNG. A rigorous pragmatic, effectiveness trial would be justified on the basis of these findings.